Maxillary Sinus

Question 1

Function of paranasal sinuses

Answer 1

• Resonance to voice
• Reduce weight of skull
• Reserve chamber for warm inspired air

Question 2

Opening of maxillary sinus

Answer 2

Osteum
4mm diameter

Question 3

Sinus epithelium

Answer 3

Pseudostratified ciliated columnar epithelium

Question 4

Function of cilia

Answer 4

Mobilise trapped contents + foreign material and move it towards the opening

Question 5

What nerve lies close to maxillary sinus

Answer 5

PSA

Question 6

Clinical significance of proximity to sinus

Answer 6

• OAC
• OAF
• Root in sinus
• Sinusitis

Question 7

What is an OAC?

Answer 7

Communication created between sinus + oral cavity

Question 8

What is an OAF?

Answer 8

Chronic problem communication between sinus and oral cavity persists, opening becomes a fistula

Question 9

Antibiotic for OAC

Answer 9

Pen V 500mg 5 days

Question 10

Surgical closure of OAC

Answer 10

3 sided buccal advancement flap

Raise full thickness mucoperiosteal flap

Question 11

Tx of OAF

Answer 11

Excision of sinus tract
Buccal advancement flap
Antral wash out

Question 12

Name examples of flap options

Answer 12

Buccal advancement flap
Buccal fat pad
Palatal flap
Bone graft

Question 13

Aetiology of maxillary tuberosity fracture

Answer 13

• Lone standing molar
• XLa in wrong order
  (always go posterior and work forward)
• Inadequate alveolar suport

Question 14

When can you leave a root in sinus?

Answer 14

When its not tore the lining of the sinus

Root wedged between lining of sinus and alveolar Bonne

Question 15

Root in sinus retrieval options

Answer 15

• Buccal advancement flap
• Caldwell luck approach
• ENT

Question 16

Aetiology of sinusitis

Answer 16

Cilia struggle to empty contents of sinus due to blockage

Their movement patterns are affected by allergies/inflammation

Obstruction of sinus opening

Question 17

Name the sinuses

Answer 17

Frontal sinus
Sphenoid sinus
Ethmoid air cells
Maxillary sinus

Question 18

Signs + symptoms of Sinusitis

Answer 18

Facial pain
Congestion
Pressure
Nasal obstruction
Fever
Headache
Dental pain
Halitosis
Fatigue
Cough
Ear pain

Question 19

Indicators of sinusitis

Answer 19

Discomfort on palpation of infraorbital region

Diffuse pain in maxillary teeth

Pain that worsens with head/facial movements

Question 20

Tx for sinusitis

Answer 20

Ephedrine nasal drops 0.5% one drop each nostril up to 3x daily

Steam

Antibiotics if symptomatic tx not effective

Amoxicillin 500mg 3x day for 7 days